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4090 Oakbrooke Alcove Use BLUE or BLACK Ink For Office Use Permit City f Ea aO I Permit Fee: I 3830 Pilot Knob Road I T Eagan MN 55122 Date Received: Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 I Staff: I I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ( /~~Z~7~/a Site Address: Tenant: X 0v~ TT- Suite RESIDENT/ OWNER Name: 1647- Phone: Address / City / Zip: Z 0, yrc' Applicant is: 4 Owner Contractor TYPE OF WORK Description of work: /"G rln 101 ov Construction Cost: /D, Multi-Family Building: (Yes / No 4-) CONTRACTOR Name: r~-rLG~i d~ License ,p lvY9a Z Address: /S'(o ,~!l~ /martZ'd City:/rst State: A41f11 Zip: a y?~~ Phone: Contaci:._-~ 171 Email: 7~-,,,4-1 C' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www._qopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Applicant's Printed Name Applicant's Signature Page 1 of 2 BiIRN,SVILLE Heating & Air Conditioning, L.L.C. 12481 Rhode Island Ave S, Sav¢gg MN 55378 • 952-894-0005 Orsht Test Report for Job# 3/ z 3 AddreSS City Occuoant rZ I 4 ? Date af Install dl ?a? la z Type of HT. F/A ?% NW Space HT. Make ( P k ^ c v- Model K,-26Q3-2? ? Serial Input Pilot Type _ Pressure _ Input CFH _ Stack Temp HOT SURFACE IGNlTOR kc Unit HT C02 t 7 02 CO c DateTested 7 12 "7 Company. Technician BURNSVILLE HEAT/NG & AlR CONDITIONING 'I L 'Lv} \a 131 k ` IESIDENTIAL 6f y gay9 C}ak6(00keV?, BUILDINC PERMIT APPLICATION 1't1lP y9aso CITY OF EAGAN I' I? ?I ?..25 I 8830 PILOT KNOB RD - 55122 ? • G,?.?y,?? 651-681-4675 New nsLUCt R ui men?1 •Pa RemodellReoairReauiremeMS • 3 registered sile surveys showing sq. R W bt, sq. of Iwuse; an II roofed areas ? a"3 9 ? • 2 copies of PWn (20% maximum bt cwerage allaved) . 1 set of Energy CalaWtions for heated additions • 2 copies of plan shawing beam 8 wintlow sizes; poured tound design, etc.) • t site survey for exterior additions 8 decks • 1 set ot Eneryy Calr la5ons • 3 apies of Tree Preservation Plan "rf lot platted afler 711193 • Rim Joisl Detal OpOOns selection sheet (bldgs wiUi 3 w less uniCS) DATE VALUATION (EXCLUDING LAND) -Ll°r?3 ? I '7o,so 9b?so l1-'D __7 -C) ( .iJB SITE ADDRESS `r0 Sv Oc.U.kzrvokc. 414_oue. IF MULTI-fAMILY BUILDING, HOW MANY UNITS? /vIA PROPERTY OWNER Pu I,k- llo...rs -54 /1'lN 6,12 TYPE OF WORK /1/e,,, Co., st?uoG?o., fIREPLACE(S) _0 Xl _2 _3 APPLICANT )P-/s4, "ow.. s o? /31i1/ Cor.o PHONE# rf Is)'/S1-SZOv ADDRESS glS Nortt c„tict f'cYrkw? s?.'•? ?YO ZIPCODE PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 (check one) - Residential VentilaGon Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted ? MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted ' Plumbing Contractor. V a PIu ,.( L) ti?3 Phone #: Ia S I "qY.2 f a) 2 J Plumbing System Include? Water Softe eiS r _ Lawn Sprinkler Fee: $90.00 ZC Water Heater ? No. of R.I. Baths 3 No. of Baths Mechanicai Contractor: 1-3u r N s U: Itc, /-c4 k1v. t, Phone # c ? 5,2l 'P y- Uo 0 5' Dlechanical S}stem Includes: Air Conditionin; Fee: $70.00 Heat Recovery System Sewer/WaterControctor. 6-?a.r?1 ypt_ -kro Phone# ?(a/y.2d'•r??/%? All above information must be submitted prior to processing of application. '?"d V I'S ?l i I hereby ocknowledge that I have read this application, state that the informati? s correct, gr complywith all applicable State of Minnesota Statutes and City of Eagan Ordinances. - r-? Signature of Appiicant Certificates of Survey Received Tree Preservation Plan Received _ Not Required ? UpdatEd 1/07 OFFICE USE ONLY ? 01 FoundaGon 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? OB 06-plex ? 16 Fireplace 13 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck O 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N REQUIRED IjdSPECTIONS _L?' FinaUC.O. ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch(screened) ? 24 Storm Damage ? 25 Miscellaneous x 31 New ? 35 Int Improvement ? 38 Demoiish (Interior) O 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair 0 33 Alteratlon O 37 Demolish (Bldg)' O 43 Reroof ' ? 46 WindowslDoors D 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy /I - 3 MC/ES System Census Code Zoning p 67 City Watei ? SAC Units Stories A Booster Pump Nbr. of Units o? Sq. Ft. /6 PRV ?? Nbr. of Bldgs ol Length ? a- Fire Sprinklered Type of Const V;V Width V ? Footings (new bldg) _ Footings (deck) Footings (addition) _k,'-Foundation ?Drain Tile Roof Ice & Water Final ?Framing L,-"?Fireplace R.I. Air Test Final 1,,*'Insulation Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total _ FinaUNo C.O. _ Plumbing _ HVAC ? 30 Accessory Bldg ? 31 Ext. Alt- Multi ? 33 Ext. AIt - SF 0 36 Multi ; . . e _ Other y _ Poo] _ Ftgs _ Air/Gas Tesu _ Final _ Siding SNcco Srone _ Windows (new/replacement) Approved By Building Inspector ? ---------------------------------z???=??`-?---? ------- l3SMY • /69,) x /"5 °? - /63&0 ?/?7oT? LvL ,??p rc/L !n 03 x54= ?y 5 'r /cI C12/1-/13 /L 41 ?h'X 16?' = 77y? pviLJ ??or" /rcc??,?p2c? ?'O 7-J91- l 3 ? A 5 f Address 409 (1 Oa k h r n n k a A 1 r n v P Zlp $5122 I.ot ? Blk s Sub Oakbracke Sth THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: Qa Yes No Inspector: r Fina] grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded gtass TraiUcurb damage ?. Porch V/ Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water suppiy to the oufside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contraclor Copy 2005 RESIDENTIAL BUILDING PERMIT APPLICATION 9 ^-1 City OF Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 a -7 C.O 3 New Construction ReauiremenLS RemodeUReoairReauirements Offlce Use OnN 3 registered stte surveys showing sq. ft. of lol, sq. R of house; and all roofed areas 2 wpies of plan CeR of Survey Recd _ Y_ N (20% maximum lot coverage allaxed) 1 set of Energy CalculaCrons for heated additiore Tree Pres Plan Recd _ Y_ N, 2 copies of plan showing beam 8 window s¢es; poured found design, etc. 1 site survey for addiGOns & decks Sree PreslRequired _ Y_ N i sel of Energy Calculations Add'Non - indicafe ilon-site seplic sysfem Onsile.Septic System _ Y_ N 3 copies of Tree Presenation Plan if lot platted after 711/93 Rim Joist Detaa Options selection sheet (buJdings with 3 or less unifs) Date 4 / Site Address k / 1,&o b 41 o-<k) pc.?'?r- ?,.oo k Construction Cost ?75-aa . A-(,r_?? Uniuste # Description ot Work -QZ_4,L Multi-Family Bld g _ Y ]lN Fireplace(s) _ 0 _ 1 _ 2 Property Owner -g?'ar Telep6one # ( LS)) (0$7 -`17 '1LI Cootractar `?N :?L Address State Z-o,. S-,7, ?3 wAti ?''"?v ?+4-. A"'t-- Zip Z? City ` Telephone#('CGZ) S10 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7690 Cate¢orv 1 Minnesota Rules 7672 Enefgy Code Category , Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitled • Energy Envelope Calculations Submitted Have you previously consiructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanicai Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and wor ' ' t a eLY'?? permit; that the work will be in accordance with the approved plan in the case of work w ?r44 approval of plans. ? ? APR o 4 2005 ? i ? w ApplicanYs PriName Applicant's Signa e !Ry OFFICE USE ONLY Sub Types ,_ . O Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? OB 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex F 18 Deck ? 23 Porch (screen/gazebo) ? 36 MuRi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex O 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types (gP 31 New ( ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 0 33 Alteration ? 37 Demolish 8uilding* O 43 Reroof O 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code 43Y Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width Footings (new bldg)- ? Footings(deck) _ Footings (addition) Foundation Drain Tile Roof [ce & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final _ Insulation . Approved By: REQUIRED INSPECTIONS _ FinaVC.O. ? FinaVNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Retaining Wall Building Inspector Base Fee Surcharge Pian Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total • Surveyor's Certificate SURVEY FOR :PULTE HOMES DESCRIBED As :Lot 2, Block 3, OAKBROOKE 5TH ADDIION, City of Eagan, Minnesota ond reserving easements of record, IND V' z 6 kkL`o 7 / ., ? . ...? ? -... _._?. ? w ? a SIiT FENGL # 18052 PROPOSED ELEVATIONS G5 . ? o? -- ? , r a ?. ?45.5 N89°58'2 "E 144.11 95.2 94b.b ? 938A ?---- Qr-- o -- T?---? ?5. 22.00 a lo Ch/ 9Q7. ?? 26.00 9.3fl. v1 Sg? o ?'rOfO(Je o ?g °?------ Proposed N 2-Story o 9'pcw 4,,09)- /` 94?.i• N890 I 58'20"E 16yr7-Z 9391 J LOT SQ. FOOTAGE = 10,261 HSE SQ. FDOTAGE = 1,664 L D T CO I/ERA GE = 16% PAV'm ME???RIEED Top of Foundation = 9145.0 Garage Floor = qq7,b Basement Floor =q39.o Aprox. Sewer 5ervice =93e.o! Proposed Elev. _ C=D Existing Elev. - - Droinage Directions =- Denotes Offset Stake = . SCALE: 1 Inch - 30 feet - vxnNr- ? 7 =7 ? o ' Z 0 9 W N I? O v p p qO ? a o A o , O y u o ? `c = o / m o J Q ` I o.v O 1 _ vwcnNr- BENCHMARK, C.P'?4013 Ek, = 423 .1.9 MIN. SETBACK REQUIREMENTS Front - House Side - Rear - Garage Side- JOB N0: HEDLUND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORREC7 REPRESENFATION 01R-521 OF THE BOUNDARIES OF THE ABOV'E DESCRIBED PROPERTY AS SIIRVEYED BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PAGE: PLANNlNC d'NGINBBRINC SURV6YINC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. 2005 Pin Oak Drive - Eagan, MN 55122 DATE CAD FILE: Phone; (651) 405-6600 ? F D. LINDGR , LAND RVEYOR Fax: (651) 405-6606 MINN SOTA LICENSE NUMBER 14376 Oakbrooke 5 ! ti , 1 ' _ ty e+ E,y-n -- ?'i iU; F;,:,,_t•IU'_. ?.3g:,,. ? i:?±`,l:n: tt):_;i1':'': i•t!Jidi?rY ?J1.'= ? {';11_; EIWti T t:F' SU.r,c?LY7=c' ii!F:rEIE a2-i0.YWv U. 00 ,J?I fil IpL-d i:;..CPi.pr 'AmfUfiY f.0 'Li U::?r ?lJgl:?';,IEiI • MRR-16-2000 10:28 P.02/a2 IMIIQOheck COMPI,IAUICE REBORT Minnaecta Energy Code MRdcheck Software veraion 3.0 COIIN'I'Y: DBkcata STAT3; Min:seaota ZONE; 2 CONATRUCTSON TYpE: S111g1e Family DATE: 3-16-2000 DATE OF PLAN9: 3/16f00 TI'1T,E: $pLKIR1C W/D EL. 02 cortPLzAacE: PASSSs Raquired T,7A = 509 Your Hcme = 407 19.94r eettsr Than Code Ber C C ecke y/DaCe Rxea ox Cavity Cont. Glaziag/DOOs perimeter R-Value R-Va::.ue II-Value _-_•-----------------------------------------'------ ^-------- ------------- CETLINGS 1444 44.0 0.0 WAT,;,S: t4ood Frame, 16^ O.C. 2327 19.0 2.0 3. NALL3: Wood PraA1e, 16° O.C. 283 10,0 2,0 ssMT; coac. 9.01 ht/a.a' bg/9.o, insul ¢oz 21.0 0.0 CT•nZING: Windowe or poosa, Above Grade 485 0.354 1 DC7QRS 38 0.330 FLOORS: 4ver Uncoaditioned 8pace 352 38.0 0.0 HVAC EQVIPMtENT; Furrlace, 92.0 AFC7E ----------- ---------`---------'-------_'_._----------------^^--- ^ .__ COMPLiANCE sTATPMSNT; The propoeed building deeign described here i?s ? ? caneisteat with the building plana, specificatione, and ether calculations aubmltted with the parmit applica*_ion. Tha propoeed building ha¢ been designed to me Mi pa"ota Eneray Code. Siilder/Desigaer Dace TOTRL P.02 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMITAPPLICATION PROPERTYLEGAL /D'k -? ?cK?d'o, kG DATE OF SURVEY: l/?a L' D l LATEST REVISION: ? ? c m cj DOCUMENT STANDARDS Y a O Z a Q 9Y 0 ? • Registered Land Surveyor signature and company v? ? • Buiiding PermB Applicant O ? • Legaldescription v / ? ? • Address 6/? ? • North arrow and scale t?'/ ? [?/ ? ? ? • • House type (rambler, walkout, split wlo, split entry, bokout, etc.) Directional drainage arrows with slopeJgradient % E? ? ? • Propased/exristing sewer and water services 8 invert elevation fV ? ? • Sheet name t(! ? ? • Driveway ? ? • LotSquare Footage ? ? • Lot Coverage Gd ? ? • Benchmark ELEVATIONS / Existin t5/ ? ? • Sewer service (or Proposed) GY ? ? • Property comers ?? ? • Top of curb at the driveway and property fine extensans ??? • Elevations af any existing adjacent homes ?[a?/ ? • Adequate footing depth of structures due to adjacent utility trenches ? d ? • Waterways (pond, stream, etc.) Prooosed / ?Y/ ? ? • Garage floor ? ? • First floor ? ? ? ? • Lowest exposed elevation (walkouUwindow) fd / ? ? • Property comers [9' ? ? • Front and 2ar af hame at the foundation PONDING AREA (iF apolicable) ? ?/ ? • Easement line 0 tr" ? • NWL ? ?/ ? • HWl ? B'?y ? • Pond # designation ? ? • Emergency Overflow Elevatan l?/ ? ? • b?"/ ? ? • fY ? ? • ? • ? ? f? • ? ? ? • DIMENSIONS Lot lines/Bearings & dimensions Right-0f-way and street width (ta back of cur6) Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requirtng pertnanent footings) Show all easements of record and any City utilities within thase easements Setbacks of proposed structure and sideyard setback of adjacent existing sWCtures Retaining wail requiremen- ffany Reviewed: Surveyor's Certificate SURVEY FOR :PULTE HOMES DESCRIBED AS :Lot 2, Block 3, OAKBROOKE 5TH ADDIION, City ot Eagan, Minnesoto and reserving easements of record. p?OY ?r ?6 ) ttl 6 151,4IU r????? ?7 ay 8.0 - w+canr- J? 995.1 445.5 N89°58'2 "E 144.11 995.2 94b.b 9389 9 l?5 94 ? 'y ,-- o--- o ---+?---- -? I ? 22.00 o ? z o ' Fa ? p 9A?. 26.00 p O Gorage 9449 h p N? ?saf. ? tio?n O .i ? Nh/ w c q° Proposed N Q 4 to o ? O Y 2-Story o 9'pcw w/o ? 01 ? 0 / N O `" 997. ° 0 0° ? O 26.00 Q SILT FENG9 N890 I 58'20°E 16T?I? 939.1 -vncnar- L O T SQ. FO D TA GE = 10,267 HSE SQ. FOOTAGE _ 1,664 L 0 T CO l/ERA GE = 16% Ixc;F /j 18052 ' r• PROPOSED ELEVATIONS Top of Foundation = qqgo Garage Floor = qqTto Basement Floor =q39,0 Aprox. Sewer Service =43e.o! Proposed Elev. Existing Elev. _ P.M.O.N. RRQURI E=. D r BENCHMARK, C.BW9013 Eku = 923.b9 MIN. SETBACK REQUIREMENTS Drainage Directions = U Front - House Side - Denotes Offset Stake = • SCALE: 1 o-,cn = 30 faet Rear - Garage Side- JOB N0: HEDLUND I HEREBY CER7IFY THAT THIS IS A 1F2UE AND CORRECT REPRESENTATION 01R-521 OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERtt AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PACE: PLANNlNG BNCIN66RINC SURVEYlNC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. 2005 Pin Oak Orive - - • ' Eogan, MN 55122 DATE -LL/??^/ ? CAD FILE: Phone: (651) 405-6600 -?LINOGR . LANO VEYOR Fax: (651) 405-6606 ?--J1MINN SOTA uCENSE NUMBER 14376 OokbfoOke 5 PERMIT# ? -5 --)-- RECEIPTDATE: 2002 RESIDEN'fla+?L PLU14IBI1VH PERMIT APPLICATION crrY oe EAs,ax 3$30 PILOT KNOB RD EAfiRN, EiN 55122 651-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITEADDRESS: 04K t4/-Od&=?lca ? P/ OWNER NAME: :ge- TELEPHONE #: 6 57/ 7WY (AREA CODE) INSTALLER NAME: c n.? ar..? ga-, TELEPHONE #: ?.SoC ??,?3 5-C,3O ? ?it?,ticau ?/ y{? ? (AREA CODE) STREET ADDRESS: CITY: pYo/??i ? STATE: ZIP: ?? I SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) includes $40.00 County fee $ 100.00 Note: Additional consuttant fees may apply . MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water soReners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: RPZ: new installationlrepair/rebuild $ 30.00 ?lawn irrigation system JUN 18 1002 ey ReplacemenUadditional: _ water softener _ water heater $ 15.00 State Surcharge $ 50 rotal $ 1 I herebyacknowledge that I have read this application, statethatthe infortnalion is correct, and agree to complywith all applicabla Cityof Eagan ordinances. It is the applicani's responsibility to notify the property owner lhat the City of Eagan assumes no liability for any damages caused by the Cityduring its normal operational and maintenance activities to the §cilities wnstruCed under this permit vilhin City pertylrighb f•yrayT?asep(?nt. ?F+.C SIOM TURE OF PERMITTEE 1102 PERMIT# RECEIPT DATE: SOOE MSIDEPTi!!L PLUM$IAfi PFJM1T lFPPLIClETIOR crrY oF EAsm s$so PI.oT KNOB ltD p f? C? ? 0 Crl ? E.GM.MN 5512E ? 651-691-4675 MAR 14 2002 Please complete for: single family dwellings, townhomes and condos when permits are required for ea unit, p backflow preventer for irrigation system BY S SITEADDRESS: v GD odw? OWNER NAME: : TELEPHONE #: ?l l?' 7 QD Op ??Q (AREA CODE) INSTALLER NAME: TELEPHONE #: 5 2 Y ? ?-? (p STREET ADDRESS: S? q?- UL4404V(- AL (AREA CODE) CITY: STATE: Md1 ZIP: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water tumaround - ewsting dwelling unit (+ 5/8" meter if needed -$118) Other: _ RPZ; new installation/repair/rebuild $ 30.00 _ lawn irrigation system ReplacemenUadditional: _ watersoftener _ waterheater $ 15.00 State Surcharge $ .50 Total $ I herebyadcnowledge that I have read this application, state thatthe information is correct, and agree to complywith all applipble City of Eagan ordinances. It is the appliranPS responsibility to notlty the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operatlonal and mainfenance activitles W tbe tacllities consWcted under this permit within C?iry?o?rry(0Mfof- ayl a?ement. lw? ? Q V ? SIGNATURE OF PERMITTEE 7102 A-(,6 0 Yr:E Site address: L967C 0311,07W? Lot _ Block Subd. On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ This sUucture: is consVucted to meet minimum requirements of the Mn Energy Code, Chapter 7670 x OR _ This sUucture: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater R j p5 .,Z?/S Furnace a 3` a 1 ?' S Y Ct?D ;.•c_ o t- Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES No Kitchen kitchen Bathroom 7 /Yj? a • n r. K4soN.`?. h V -DS V Bathroom 2 794 54- KG$ D-4 F? F- y_ V Bathroom 3 Bathroom 4 Other FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT AiM05 1J 6- I? CC D 712- 3 7 7 ooa ? I hereby ackn ledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan require enz./? l, ignature/7? f CompanyName Z6 Z Date This form is the responsibility of the General ConVactor. Use BLUE or BLACK Ink I For Office Use I I I I Permit City of Ea~a~ D, I Permit Fee: 191 I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I it-[ 2013 RESIDENTIAL BUILDING/ PERMIT APPLICATION Date: C`/ 3 Site Address: C(C)g (--3 Unit Name: Phone: Resident/ Owner Address /City /Zip: Lc- Applicant is: Owner Contractor Type of Work Description of work: Construction Cost: 1~;r Multi-Family Building: (Yes / No ) I Company: (/A (A1,1 Contact: Address: 6 UZ ?U s1 , City: S~ Contractor State: A41 Zip: q Cr Phone: S v '1 3 v► License #:I C 6y ~tJ3~ Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)® COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: I Licensed Plumber: Phone: I Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: j a NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plarIK"k Exterior work authorized b a building permit issued in accordance with the Minnesota Sta B ildi g Code must be completed within 180 days of ermit issuance. X r^ x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA125684 Date Issued:07/30/2014 Permit Category:ePermit Site Address: 4090 Oakbrooke Alcove Lot:2 Block: 1 Addition: Oakbrooke 7th PID:10-53766-01-020 Use: Description: Sub Type:Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of house wrap and leave on site for final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Brett Peterson 4090 Oakbrooke Alcove Eagan MN 55122 Minnesota Exteriors 8600 Jefferson Hwy Osseo MN 55369 (763) 391-5514 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA146589 Date Issued:11/02/2017 Permit Category:ePermit Site Address: 4090 Oakbrooke Alcove Lot:2 Block: 1 Addition: Oakbrooke 7th PID:10-53766-01-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Brett Peterson 4090 Oakbrooke Alcove Eagan MN 55122 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA171039 Date Issued:07/28/2021 Permit Category:ePermit Site Address: 4090 Oakbrooke Alcove Lot:2 Block: 1 Addition: Oakbrooke 7th PID:10-53766-01-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Brett Peterson 4090 Oakbrooke Alcove Eagan MN 55122--550 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA178410 Date Issued:08/16/2022 Permit Category:ePermit Site Address: 4090 Oakbrooke Alcove Lot:2 Block: 1 Addition: Oakbrooke 7th PID:10-53766-01-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Brett Peterson 4090 Oakbrooke Alcove Eagan MN 55122--550 Pcs Residential 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature